• Title/Summary/Keyword: Pain Care

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Multiparous Women's Experience of Labor Pain : Pheminological Method (경산모의 분만통증 경험에 관한 연구)

  • Yeo, Jung-Hee
    • Women's Health Nursing
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    • v.5 no.3
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    • pp.277-286
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    • 1999
  • Pain is a complex perceptual experience that is profoundly influenced by a number of variables, differing in quality as well as in intensity. Therefore we need to understand the actual experience of multiparous women in order to provide basic information for nursing care. The purpose of the study is to explore the experience of labor pain. The data are collected through in-depth interviews of 17 multiparous women in city of Pusan from October 1998 to March 1999. The interviews were conducted 1-2 days after delivery in the admission room. Each interview lasted about 45 minutes on average. Subjects were interviewed one at a time. The interviews were recorded with the consent of the subject. Data were analyzed by means of Giorgi's Phenomenological analysis methods and categorized according to the similarities of its contents. The investigator read the data repeatedly to identify themes and categories. Six categories that were identified were : 1) pain 2) regret 3) acceptance 4) maturity 5) accomplishment 6) newness. Under these categories there were seventeen themes. I. Pain: 1) too dependent on others 2) too painful 3) fear or anxiety from previous painful experience 4) avoidance of pain 5) couldn't control the pain II. Regret : 1) spouse's absence 2) unprofessional attitude of the staff 3) ignorance of other's towards their pain III. Acceptance : 1) took the pain for granted 2) accepted the pain as fate 3) endured the pain IV. Maturity : 1) appreciated the value of life 2) apprehension of parent V. Accomplishment : 1)is over sense of accomplishment 2) grateful the pain VI. Newness : 1) experienced a new feeling 2) quickly forgot the pain. The results of the study will provide basic data for labor pain management.

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Usefulness of four commonly used neuropathic pain screening questionnaires in patients with chronic low back pain: a cross-sectional study

  • Gudala, Kapil;Ghai, Babita;Bansal, Dipika
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.51-58
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    • 2017
  • Background: Recently symptoms-based screening questionnaires have gained attention for screening for a neuropathic pain component (NePC) in various chronic pain conditions. The present study assessed the usefulness of four commonly used NePC screening questionnaires including the Self-completed douleur neuropathique 4 (S-DN4), the ID Pain, the painDETECT questionnaire (PDQ), and the Self-completed Leeds Assessment of neuropathic Symptoms and Signs (S-LANSS) questionnaire in patients with chronic low back pain (CLBP) to assess the presence of NePC. Methods: This is a single-center cross-sectional study where patients with CLBP, with or without leg pain, were included. Participants were initially screened for NePC presence by a physician according to the regular practice, and later assessed using screening questionnaires. The diagnostic accuracy of these questionnaires was compared assuming the physician-made diagnosis as the gold standard. Results: A total of 215 patients with CLBP of which 164 (76.3%, 95% CI, 70.2-81.5) had a NePC were included. S-DN4, ID Pain, and PDQ have an area under the curve (AUC) > 0.8 indicating excellent discrimination. However, S-LANSS has an AUC of 0.69 (0.62-0.75), indicating low discrimination. S-DN4 has a significantly higher AUC as compared to ID Pain (d(AUC) = 0.063, P < 0.01) and S-LANSS (d(AUC) = 0.197, P < 0.01). But the AUC of S-DN4 does not significantly differ from that of PDQ (d(AUC) = 0.013, P = 0.62). Conclusions: S-DN4, ID Pain, and PDQ, but not S-LANSS, have good discriminant validity to screen for NePCs in patients with CLBP. Despite using all the tests, 20-30% of patients with an NePC were missed. Thus, these questionnaires can only be used as an initial clue in screening for NePCs, but do not replace clinical judgment.

High-impact chronic pain: evaluation of risk factors and predictors

  • Ilteris Ahmet Senturk;Erman Senturk;Isil Ustun;Akin Gokcedag;Nilgun Pulur Yildirim;Nilufer Kale Icen
    • The Korean Journal of Pain
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    • v.36 no.1
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    • pp.84-97
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    • 2023
  • Background: The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP. Methods: Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores. Results: One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.98; P = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01-1.12; P = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; P < 0.001). Conclusions: This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.

Neuropathic pain feature in cancer-induced bone pain: does it matter? a prospective observational study

  • Nantthasorn Zinboonyahgoon;Choopong Luansritisakul
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.253-267
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    • 2023
  • Background: Cancer-induced bone pain (CIBP) is considered to have both nociceptive and neuropathic components. However, the prevalence, risk factors, and impact of the neuropathic components are yet poorly understood. Methods: We estimate the prevalence of neuropathic pain (NP) features in patients with CIBP at a tertiary care pain clinic setting using the Douleur Neuropathique 4 questionnaire and evaluate their associated factors and their impact after 4 weeks of treatment using the Brief Pain Inventory questionnaire and the Edmonton Symptom Assessment System. Results: A total of 133 patients were recruited. The estimated prevalence of NP was 30.8% (95% confidence interval: 23.6%-39.1%). Initially, the patients with NP had significantly higher average pain scores (6.00 vs. 5.05, P = 0.006), higher total interference scores (5.84 vs. 4.89, P = 0.033), and symptom distress scores (35.88 vs. 26.52, P = 0.002). After 4 weeks of treatment, patients in both groups reported significantly decreased pain intensity and improved quality of life. However, the patients with NP still reported significantly higher average pain (4.61 vs. 3.58, P = 0.048), trending toward higher total interference scores (3.52 vs. 2.99, P = 0.426), and symptom distress scores (23.30 vs. 20.77, P = 0.524). From multivariate analysis, the independent risk factors for NP were younger age, pain in the extremities, and higher average pain scores. Conclusions: NP are common in patients with CIBP. These conditions negatively affect pain intensity and the patient's quality of life before and after treatment.

Initial Assessment and Care Planning in Palliative Hospice Care: Focus on Assessment Tools (호스피스 완화의료에서의 초기평가와 돌봄 계획의 수립: 평가도구를 중심으로)

  • Park, Eun Ju;Koh, Su Jin;Cheon, Jae Kyung
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.67-76
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    • 2019
  • For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.

Factors Influencing Quality of Life in the Community Dwelling Vulnerable Older women with Chronic Joint Pain (만성 관절통증이 있는 취약계층 재가 여성노인의 삶의 질에 영향을 미치는 요인)

  • Yoo, Jae-Soon;Ham, In-Suk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.355-367
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    • 2018
  • The purpose of this study was to identify the predictors of the quality of life in community dwelling vulnerable older women with chronic joint pain. A cross-sectional study was conducted on 234 participants registered at a visiting health care service in the public health center of C-city. The structured questionnaire were used to collect data on the general characteristics, pain rating index, pain intensity, perceived health status, functional independence, sleep pattern, depression, and quality of life from February 16 to March 13, 2017. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients, and hierarchical multiple regression analysis. The significant factors of the quality of life including general characteristics were depression (${\beta}=-.60$, p<.001), pain intensity scale (${\beta}=-.15$, p=.007), health insurance type (${\beta}=.15$, p=.001), perceived health status (${\beta}=.14$, p=.007), duration of pain (${\beta}=-.10$, p=.019), marital status (${\beta}=.10$, p=.024), and functional independence (${\beta}=.09$, p=.036). These factors accounted for 63.1% of the total variance in the quality of life. The findings suggest that a public healthcare program on managing depression is effective in improving the quality of life in community dwelling older women with chronic joint pain. Public health nurses should intervene in nursing care for economically vulnerable aged and pain management based on a precise assessment from the beginning of pain.

A Study on the Childbirth Experience in Primiparas (출산경험에 대한 연구)

  • Kim, Hyun-Kyung
    • Women's Health Nursing
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    • v.1 no.1
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    • pp.81-96
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    • 1995
  • This study was intended to provide women who are supposed to experience childbirth with effective nursing care exploring the childbirth experience. The purpose of this paper is to give an answer to the question of what the childbirth experience is, and phenomenological method has been used for that purpose. 17 primiparous mothers right after delivery in one university hospital of J city were served as subjects for this research. Data were collected June to October, 1993 through in depth interview with subjects using unstructured and open questions about the childbirth experience. Van Kaam's phenomenological analysis method was used for the analysis of the data. The results of the study are summarized as follows : The contents of the experience which primiparous mothers had undergone through childbirth were pain, fear, worry, relief, lightness, thankfulness, unsatisfactory, unreality, holiness for a new life, identifying the meaning of life, becoming a mother. 1. Experience before delivery Mothers experienced pain, fear, worry, unsatisfactory, relief, and thankfulness before delivery. Subjects' descriptions about the pain appeared to be various ; unbearable pain, bearable pain, anticipated pain. And their reactions were also various ours ; some endured pain, sought alternative method i.e., surgery, didn't want to reexperience it, or accepted it as women's fate. Subjects experienced fear for anticipated pain, suffering pain, and possible delayed delivery progress and were worried about delivery progress and baby wellbeing. Also, Subjects were unsatisfied with professionals' unfaithful attitude, their spouses' absence, and the ignorance of their pain. But subjects became relieved at the accustomed surroundings, good progress of delivery, support of family, care of professionals and support of other family. And they expressed their thanks to the professionals and family members for doing their best and also to their mothers who gave birth to them. 2. Experience after delivery Subjects experienced lightness, thankfulness, unsatisfactory, worry, unreality, holiness for a new life, identifying the meaning of life, becoming a mother after delivery. Mothers experienced lightness from the fact that it is over, and freshness right after delivery. They were thankful that they delivered vaginally and had an easy delivery. Subjects who delivered female baby were unsatisfied and some were worried about rearing the baby. By confessing, "I have no specific feeling, I am very confused, It is unrealistic, I feel strange", they expressed the unrealistic aspect of childbirth experience. Subjects felt holiness for a new life for novelty and birth of life. They identified the meaning of life from the fact that they felt worthy, fulfilled their duty, had their own baby, accomplished an important affair. After they experienced what it is to be a mother, they realized with it is being a mother and had a rearing expectation for the baby. The results of the study will provide basic data for caring the childbearing women.

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Knowledge and Attitudes toward Palliative Terminal Cancer Care among Thai Generalists

  • Budkaew, Jiratha;Chumworathayi, Bandit
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6173-6180
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    • 2013
  • Background: Our objective was to determine the knowledge and attitudes of Thai generalists (general physicians) toward palliative terminal cancer care (PC) in a primary care setting. Materials and Methods: We performed a cross-sectional descriptive survey using a self-administered questionnaire. The total number of completed and returned questionnaires was 63, giving a 56% response rate. Data analysis was based on these (Cronbach's alpha=0.82) and percentages and mean values were assessed using the Fisher's exact test to determine the correlation of variables. Results: Overall, attitude and knowledge levels were slightly satisfactory. Results indicated that general physicians had moderate scores in both attitudes (84.1%) and knowledge (55.7%) regarding palliative terminal cancer care. However, they had insufficient knowledge regarding truth telling, pain control and management with morphine, emergency management in terminal cancer care and treatment of fluid intake in terminal stages. Attitude and knowledge scores were statistically correlated (p=0.036). Knowledge scores were further positively associated with being taught palliative care in their medical curriculum (p=0.042). Conclusions: Formal education in palliative care and development of palliative care services are very much needed in Thailand to provide holistic care to terminally ill patients.

Effects of Distraction using Balloon Art on Pain during Intravenous Injections in Preschool Children (풍선 아트를 이용한 관심 전환이 학령전기 아동의 정맥 주사 삽입 시 통증에 미치는 효과)

  • Koo, Hyun-Young;Lim, Jung-Hae;Park, Ho-Ran
    • Child Health Nursing Research
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    • v.13 no.1
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    • pp.66-72
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    • 2007
  • Purpose: This study was done to evaluate the effects of distraction using balloon art on pain experienced by preschool children when undergoing an intravenous injection. Methods: Participants were 40 hospitalized preschool children. Children in the experimental group (20) were distracted by balloon art while undergoing an intravenous injection. Children in the control group (20) received regular care. Pain experienced by the children was measured using self-report, observation tools, heart rate and oxygen saturation. The data were analyzed using the SAS program. Results: Compared with the control group, children in the experimental group showed significant difference in pain as shown by pulse rate. However, children in the experimental group did not show a decrease in pain in the self-report or behavior observation when compared with children in the control group. Conclusion: Distraction using balloon art can be used to reduce pain for preschool children when undergoing an intravenous injection. Further nursing interventions need to be developed and provided to preschool children when undergoing painful procedures.

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Effects of SP-6 Seoam Pellet Therapy on Menstrual pain, Menstrual distress and Difficulty of ADL in Female University Students (삼음교(SP-6) 압봉요법이 여대생의 월경통, 월경불편감, 월경관련 일상생활수행정도의 어려움에 미치는 효과)

  • Kim, In Kyung;Kim, Ji Hyun
    • Journal of Korean Public Health Nursing
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    • v.28 no.2
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    • pp.187-199
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    • 2014
  • Purpose: The purpose of this study was to investigate the effects of SP-6 Seoam pellet therapy given to female university students in terms of menstrual pain, menstrual distress, and ADL difficulties. Methods: This study used a pre-test, post-test design with a nonequivalent control group. The participants were 68 female students in two universities. The experimental group(n=34) received Seoam pellet therapy at Sanyinjiao while the control group(n=34) received sham therapy. Data were collected from Sep. 16 to Nov. 30, 2012. Severity of menstrual pain, menstrual distress, and difficulty of ADL were assessed prior to and following treatment. Independent t-test, $x^2$ test, and repeated measures ANOVA were used for examination of group differences using the SPSS/WIN program. Results: Severity of menstrual pain (F=41.09, p<.001), menstrual distress (F=56.31, p<.001), and ADL difficulties (F=46.64, p<.001) showed a significant decrease in the experimental group compared to the control group. Conclusion: Results indicate that this Seoam pellet therapy is effective in reducing menstrual pain, menstrual distress, and difficulty of ADL. Therefore, use of this method is recommended for relief of menstrual pain and menstrual distress through self-care.